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cn <br /> CITY OF EVERETT <br /> FINAL CONTRACT VOUCHER CERTIFICATION <br /> DATE: March 17, 2016 ADDRESS: 19300 NE 112`h Ave, Ste 100 <br /> CONTRACTOR: Shearer& Associates CITY/STATE: Battle Ground WA 98604 <br /> PROJECT TITLE: Reservoir#6 Roof Replacement WORK ORDER NO. UP 3500 <br /> DATE WORK COMPLETE: February 16, 2016 FINAL AMOUNT: $4,851,684.75 <br /> Exclusive of State Sales Tax <br /> CONTRACTOR'S CERTIFICATION <br /> I, the undersigned, having first been duly sworn, certify that the attached bill is a proper charge for work <br /> performed and material furnished to the City of Everett, that the same or any part thereof has not been paid, and <br /> that I am authorized to sign for the claimant; that I have not rented or purchased any equipment or materials <br /> from any employee of the City; I further certify that the attached final estimate is a true and correct statement <br /> showing all the monies due me from the City of Everett under this contract; that I have carefully examined said <br /> final estimate and understand the same and that I hereby release the City of Everett from any and all claims of <br /> whatsoever nature which I may have, arising out of the performance of said contract, which are not set forth in <br /> said estimate. <br /> X X P/1�Tii�/i. LY Z <br /> 41-NT CTOR TITLE c;. 2 <br /> Shearer & Associates t") w <br /> 543 12i c; <br /> Subscribed a sworn before me this „ day of .,-c. , 2016 C. N <br /> T.. ''yy. (fj , <br /> 6.J <br /> 1:. �:.� C. (R <br /> Notary Public _• <br /> in and for the State of Washington, residing at -1 'tSj <br /> PUBLIC WORKS DEPARTMENT CERTIFICATION <br /> I Certify the attached final estimate to be <br /> based upon actual measurements and to <br /> be true and correct. APPROVED D, • r 12 <br /> X �� a/ X / I� <br /> Construction Manager Publiew�'�r rector 111P.- <br /> Tom Fuchs Dave Davis <br /> INSTRUCTIONS <br /> The Affidavit of Wages Paid must be prepared by the prime contractor, all subcontractors, and all subcontractor's <br /> agents and forwarded with the Final Contract Voucher Certification. <br /> Contractor's Claims, if any, must be included and the Contractor's Certification must be labeled indicating a claim <br /> attached. <br /> Revised 6/2012 <br />